Bill Text: NY A07184 | 2023-2024 | General Assembly | Amended
Bill Title: Makes technical, minor and coordinating amendments regarding health care agents and proxies, decisions under the family health care decisions act, and nonhospital orders not to resuscitate.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Engrossed) 2024-05-14 - REFERRED TO HEALTH [A07184 Detail]
Download: New_York-2023-A07184-Amended.html
STATE OF NEW YORK ________________________________________________________________________ 7184--A 2023-2024 Regular Sessions IN ASSEMBLY May 12, 2023 ___________ Introduced by M. of A. PAULIN -- read once and referred to the Committee on Health -- recommitted to the Committee on Health in accordance with Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the public health law, in relation to making technical, minor and coordinating amendments regarding health care agents and proxies, decisions under the family health care decisions act, and nonhospital orders not to resuscitate The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Paragraph (b) of subdivision 1 of section 2981 of the 2 public health law, as added by chapter 752 of the laws of 1990, is 3 amended to read as follows: 4 (b) For the purposes of this section, every adult shall be presumed 5 competent to appoint a health care agent unless such person has been 6 adjudged incompetent or otherwise adjudged not competent to appoint a 7 health care agent, or unless a [committee or] guardian of the person has 8 been appointed for the adult pursuant to article [seventy-eight] eight- 9 y-one of the mental hygiene law or article seventeen-A of the surro- 10 gate's court procedure act. 11 § 2. Subdivision 2 of section 2982 of the public health law, as 12 amended by chapter 230 of the laws of 2004, is amended to read as 13 follows: 14 2. Decision-making standard. After consultation with a licensed physi- 15 cian, registered nurse, physician assistant, nurse practitioner, 16 licensed psychologist, licensed master social worker, or a licensed 17 clinical social worker, the agent shall make health care decisions: (a) 18 in accordance with the principal's wishes, including the principal's 19 religious and moral beliefs; or (b) if the principal's wishes are not 20 reasonably known and cannot with reasonable diligence be ascertained, in 21 accordance with the principal's best interests; provided, however, that EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD05270-04-4A. 7184--A 2 1 if the principal's wishes regarding the administration of artificial 2 nutrition and hydration are not reasonably known and cannot with reason- 3 able diligence be ascertained, the agent shall not have the authority to 4 make decisions regarding these measures. 5 § 3. Subdivision 3 of section 2983 of the public health law, as 6 amended by chapter 342 of the laws of 2018, is amended to read as 7 follows: 8 3. Notice of determination. Notice of a determination that a principal 9 lacks capacity to make health care decisions shall promptly be given: 10 (a) to the principal, orally and in writing, where there is any indi- 11 cation of the principal's ability to comprehend such notice; (b) to the 12 agent; (c) if the principal is in or is transferred from a mental 13 hygiene facility, to the facility director; and (d) to the [conservator14for, or committee of, the principal] guardian of the principal, if any. 15 § 4. The opening paragraph of section 2992 of the public health law, 16 as amended by chapter 93 of the laws of 2014, is amended to read as 17 follows: 18 The health care provider[, the conservator for, or committee] of the 19 principal under article eighty-one of the mental hygiene law or article 20 seventeen-A of the surrogate's court procedure act, members of the prin- 21 cipal's family, a close friend of the principal as defined in subdivi- 22 sion [five] four of section [two thousand nine] twenty-nine hundred 23 [sixty-one] ninety-four-a of this chapter, or the commissioner [of24health], the commissioner of mental health, or the commissioner of 25 developmental disabilities may commence a special proceeding pursuant to 26 article four of the civil practice law and rules, in a court of compe- 27 tent jurisdiction, with respect to any dispute arising under this arti- 28 cle, including, but not limited to, a proceeding to: 29 § 5. Section 2993 of the public health law, as amended by chapter 672 30 of the laws of 2019, is amended to read as follows: 31 § 2993. Regulations. The commissioner [of health], in consultation 32 with the commissioners of the office of mental health and the office for 33 people with developmental disabilities, shall establish such regulations 34 as may be necessary for the implementation of this article, subject to 35 the provisions of subdivision two of section [two thousand nine] twen- 36 ty-nine hundred ninety-one of this article. 37 § 6. Subdivisions 17 and 26 of section 2994-a of the public health 38 law, as added by chapter 8 of the laws of 2010, are amended to read as 39 follows: 40 17. "Health or social [service] services practitioner" means a regis- 41 tered professional nurse, nurse practitioner, physician, physician 42 assistant, psychologist, licensed master social worker, or licensed 43 clinical social worker, licensed [or], certified [pursuant to] or 44 authorized under the education law acting within [his or her] such 45 health or social services practitioner's scope of practice. 46 26. "Person connected with the case" means the patient, any person on 47 the surrogate list, a parent or guardian of a minor patient, the hospi- 48 tal administrator, an attending [physician] practitioner, any other 49 health or social services practitioner who is or has been directly 50 involved in the patient's care, and any duly authorized state agency, 51 including the facility director or regional director for a patient 52 transferred from a mental hygiene facility and the facility director for 53 a patient transferred from a correctional facility. 54 § 7. Subdivision 3 of section 2994-e of the public health law, as 55 amended by chapter 708 of the laws of 2019, is amended to read as 56 follows:A. 7184--A 3 1 3. Decision-making standards and procedures for emancipated minor 2 patient. (a) If an attending practitioner determines that a patient is 3 an emancipated minor patient with decision-making capacity and documents 4 the basis for that determination in the patient's medical record, the 5 patient shall have the authority to decide about life-sustaining treat- 6 ment. [Such] That authority shall include a decision to withhold or 7 withdraw life-sustaining treatment if an attending practitioner and the 8 ethics review committee determine that the decision accords with the 9 standards for surrogate decisions for adults, and the ethics review 10 committee approves the decision. 11 (b) If the hospital can with reasonable efforts ascertain the identity 12 of the parents or guardian of an emancipated minor patient, the hospital 13 shall make diligent efforts to notify such persons, and documents such 14 diligent efforts in the patient's medical record, prior to withholding 15 or withdrawing life-sustaining treatment pursuant to this subdivision. 16 § 8. Subparagraph (iv) of paragraph (b) of subdivision 4 of section 17 2994-m of the public health law, as amended by chapter 708 of the laws 18 of 2019, is amended to read as follows: 19 (iv) Following ethics review committee consideration of a case 20 concerning the withdrawal or withholding of life-sustaining treatment, 21 treatment shall not be withdrawn or withheld until the hospital makes 22 diligent efforts to inform the persons identified in subparagraph (iii) 23 of this paragraph have been informed of the committee's response to the 24 case and documents the diligent efforts in the patient's medical record. 25 § 9. Section 2994-u of the public health law, as added by chapter 8 of 26 the laws of 2010, is amended to read as follows: 27 § 2994-u. Rights to be publicized. The commissioner shall prepare a 28 statement summarizing the rights, duties, and requirements of this arti- 29 cle and shall require that a copy of such statement be furnished to 30 [patients] a patient or to [persons on] the patient's surrogate [list31known to the hospital], or to the [parents or guardians] parent or guar- 32 dian of a minor [patients] patient, at or prior to admission to the 33 hospital, or within a reasonable time thereafter, and to [each member of34the hospital's staff directly involved with patient care] any person on 35 the surrogate list who requests a copy of the statement from the hospi- 36 tal. The statement shall also be made available to the hospital clinical 37 staff. 38 § 10. The commissioner of health shall revise the statement of rights 39 that hospitals are required to post (known as the Patient's Bill of 40 Rights) under paragraph (g) of subdivision 1 of section 2803 of the 41 public health law, by replacing the clause regarding orders not to 42 resuscitate with a statement that more generally informs patients of 43 their right to receive from the hospital upon admission, and upon 44 request, a more complete statement of their rights with respect to 45 deciding about health care, including appointing a health care agent, 46 consenting to do-not-resuscitate orders and making other life-sustaining 47 treatment decisions. The clause should also state in substance that the 48 hospital will also provide such statement upon request to any family 49 member or friend of a patient who lacks decision-making capacity. 50 § 11. Subdivisions 12 and 13 of section 2994-aa of the public health 51 law, subdivision 12 as amended by chapter 672 of the laws of 2019 and 52 subdivision 13 as amended by chapter 167 of the laws of 2011, are 53 amended to read as follows: 54 12. "Mental hygiene facility" means a residential facility operated or 55 licensed by the office of mental health [or the office for people with56developmental disabilities].A. 7184--A 4 1 13. "Nonhospital order not to resuscitate" means an order that directs 2 emergency medical services personnel, hospice personnel, home care 3 services agency personnel and hospital emergency services personnel not 4 to attempt cardiopulmonary resuscitation in the event a patient suffers 5 cardiac or respiratory arrest. 6 § 12. Subdivisions 2 and 6 of section 2994-dd of the public health 7 law, as amended by chapter 708 of the laws of 2019, are amended to read 8 as follows: 9 2. A nonhospital order not to resuscitate shall be issued upon a stan- 10 dard form prescribed by the commissioner. [The commissioner shall also11develop a] A standard bracelet or other article that may be worn by a 12 patient with a nonhospital order not to resuscitate to identify that 13 status; provided, however, that no person may require a patient to wear 14 such a bracelet and that no person may require a patient to wear such a 15 bracelet as a condition for honoring a nonhospital order not to resusci- 16 tate or for providing health care services. 17 6. The commissioner may authorize the use of one or more alternative 18 forms for issuing a nonhospital order not to resuscitate (in place of 19 the standard form prescribed by the commissioner under subdivision two 20 of this section). Such alternative form or forms may also be used to 21 issue a non-hospital do not intubate order. Any such alternative forms 22 intended for use for persons with developmental disabilities or persons 23 with mental illness who are incapable of making their own health care 24 decisions or who have a guardian of the person appointed pursuant to 25 article eighty-one of the mental hygiene law or article seventeen-A of 26 the surrogate's court procedure act must also be approved by the commis- 27 sioner of developmental disabilities or the commissioner of mental 28 health, as appropriate. An alternative form under this subdivision shall 29 otherwise conform with applicable federal and state law. This subdivi- 30 sion does not limit, restrict or impair the use of an alternative form 31 for issuing an order not to resuscitate in a general hospital or resi- 32 dential health care facility under article twenty-eight of this chapter 33 or a hospital under subdivision ten of section 1.03 of the mental 34 hygiene law or a developmental disabilities services office under 35 section 13.17 of the mental hygiene law. 36 § 13. Section 2994-gg of the public health law, as added by chapter 8 37 of the laws of 2010, is amended to read as follows: 38 § 2994-gg. Immunity. No person shall be subjected to criminal prose- 39 cution or civil liability, or be deemed to have engaged in unprofes- 40 sional conduct, for honoring reasonably and in good faith pursuant to 41 this [section] article a nonhospital order not to resuscitate, for 42 disregarding a nonhospital order pursuant to section twenty-nine hundred 43 ninety-four-ee of this article, or for other actions taken reasonably 44 and in good faith pursuant to this [section] article. 45 § 14. This act shall take effect on the ninetieth day after it shall 46 have become a law, provided that the amendments to article 29-C of the 47 public health law shall apply to decisions made pursuant to health care 48 proxies created prior to the effective date of this act as well as those 49 created thereafter.
